Quantification of Portal Vein Vascularization Using an Automated Post-Processing Video Analysis Tool

Area of Science:

• Medical imaging and diagnostics
• Hepatology and gastroenterology
• Cardiovascular physiology

Background:

• Blood flow dynamics are crucial for diagnosing various diseases, yet a standardized reference method is lacking.
• Pulsed-wave Doppler (PW-Doppler) is clinically used for visceral blood flow assessment but has limitations.
• Pixel flow analysis (PFA), an innovative ultrasound algorithm, offers quantitative analysis of Doppler patterns and shows promise in obstetrics but needs evaluation for portal venous assessment.

Purpose of the Study:

• To evaluate the applicability and correlation of pixel flow analysis (PFA) with conventional pulsed-wave Doppler (PW-Doppler) for portal venous blood flow assessment.
• To compare PFA and PW-Doppler measurements in healthy volunteers and patients with hepatic steatosis and liver cirrhosis.

Main Methods:

• A prospective exploratory study involving 20 healthy volunteers, 10 patients with hepatic steatosis, and 10 patients with liver cirrhosis.
• Portal venous flow was measured using both PFA and PW-Doppler techniques.
• Comparative analysis of measurements between the two methods across different study groups.

Main Results:

• In healthy volunteers, PFA and PW-Doppler demonstrated a strong positive correlation (r=0.69) in fasting conditions.
• In patients with liver cirrhosis, a good correlation (r=0.61) was observed between PFA and PW-Doppler.
• A poor correlation (r=-0.09) was found between PFA and PW-Doppler in patients with hepatic steatosis.

Conclusions:

• Pixel flow analysis (PFA) shows high agreement with PW-Doppler for assessing portal venous vascularization in healthy individuals and liver cirrhosis patients.
• PFA presents a potential alternative to conventional PW-Doppler sonography for visceral blood flow diagnostics.
• Further research is warranted to fully establish PFA's role in clinical practice.